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Contact Information

THOMAS G ODANIEL JR, MD
222 S 1ST ST
SUITE 100
LOUISVILLE, KY40202-1350
 Phone: 502-584-1109
 Fax: 502-589-6882
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Plastic and Reconstructive Surgery

2086S0122X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for THOMAS G ODANIEL JR · (Male)

NPI Number 1871585018
Status Active
Credentials MD
Entity Individual
Enumeration date 08/15/2005
Last updated 04/04/2016 - About 10 years ago
Sole proprietor 1 Yes
Identifiers
  • KY License # 24070
  • IN Medicaid 100033340A
  • KY Medicaid 64240708
  • KY Other 000000219660 ANTHEM PIN
  • KY Other 002 CIGNA
  • KY Other 667357 HEALTHLINK
  • KY Other KY1118 HEALTHNET PIN
  • KY Other 1058697 PASSPORT PIN
  • KY Other KY0057799 TRICARE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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